News From Around the Web
> A Detroit neurosurgeon pleaded guilty to an $11 million Medicare fraud scheme in which he caused serious bodily injury to patients by performing unnecessary spinal surgeries, according to the Department of Justice (DOJ). Aria O. Sabit, who owned and operated the Michigan Brain and Spine Physicians Group, convinced patients to undergo spinal fusion surgeries and falsified operative reports knowing they would support his false claims. He then billed Medicare for spinal implants that he never actually used. Statement
> The former owner of a Los Angeles medical supply company was sentenced to seven years in prison and ordered to pay $1.7 million in restitution for submitting false claims to Medicare for durable medical equipment, including power wheelchairs, the DOJ said. Hakop Gambaryan billed Medicare more than $3 million for the unnecessary equipment during a six-year period while also paying kickbacks to clinics to obtain fraudulent prescriptions for the equipment. Statement
> The owners, operators and manager of two California nursing homes paid $3.8 million to settle allegations for substandard or worthless services. Prosecutors allege that Country Villa Watsonville East Nursing Center and Country Villa Watsonville West Nursing and Rehabilitation Center overmedicated elderly residents resulting in various adverse events including falls, fractures and, in some cases, premature death, rendering medical services worthless. Statement
Health Payer News
> CareFirst BlueCross BlueSheild announced a cyberattack that exposed information of 1.1 million consumers, including names, birthdates, email addresses, and subscriber identification numbers. Although CareFirst did not identify who was responsible for the hack, media reports pointed to Chinese hackers. Article
> CMS has released proposed changes to Medicaid managed care organization regulations. The proposed rule updates regulations from 2002, addressing issues such as electronic access, provisions for continuity of care between Medicaid and Medicare, and stronger protections for beneficiaries. Article
And finally… Here's a new TV show idea: Naked and stuck on a drawbridge. Article